Term
what to do when working with children who show low volition |
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Definition
start with things at the exploration level then progress toward competence andachievement |
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Term
striving for confidence leads to |
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Definition
skill development and the organization of these skills into habits |
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Term
according to MOHO what is an important developmental steps for those developmentally behind their peers? |
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Definition
Occupational choice.
It requires that the child have both interests and some sense of efficacy |
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Term
RTEP Resident Trainee Employment Program |
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Definition
Its in the book as a 12 week part-time paid employment for residents of a facility. The trainee program assists in establishing a work history, reviewing employment interests, addressing transferable work skills and habits for future employment and identifying skills and habits for future employment and identifying potential barriers associated with returning to work. |
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Term
The 6 step reasoning process according to the article about using Theory and the Therapeutic Reasoning Process to Guide the OT Process for Older Adults with Mental Illness |
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Definition
1. generate clinical questions based on the concepts of the theoretical model
2. collecting information from the person, through formal and informal means
3. creating a picture of that person's experience 4. Working with the person to generate the intervention plan; including goals and strategies 5. implementing the plan 6. evaluating the outcomes |
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Term
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Definition
Three groups
One group received no intervention
One group was encouraged to attend social activities
One group received both group and individual occupational therapy sessions
In the OT group they were taught the importance of continued participation and were given skills to stay active in occupations.
Individual sessions helped them apply the lessons to their own situations
5 assessments done at the end both control groups showed a decline in all indicators
The intervention group showed improvement in all indicators except three and declined significantly less in those.
The results provide strong support for making participation in occupation the desired outcome of occupational therapy intervention |
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Term
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Definition
theory that states that people with alzheimer's disease will regress cognitively in the same pattern and time frame as infants and children develop |
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Term
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Definition
developed by MSW after observing how her interaction with older adults affected their happiness and acceptance of the disease process
Two principles to validation 1. participation in present reality requires fair function of eyesight, hearing and memory-without these, people will retreat to their memories, often those that are tinged by emotion
2. Older adults must go through a process of resolution and will do so regardless of their stage of dementia.
When using this therapy clinical questions are created to explore the relationship between past occupational participation and current emotional response to daily situations. |
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Term
Important note on those in extended care facilities |
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Definition
2/3 of them meet the criteria for a psychiatric diagnosis |
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Term
Suicide and older adults (according to one of the articles) |
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Definition
75% of older adults visited their primary care physician within a month of their suicide.
16% of all suicides are among adults over 65 |
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Term
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Definition
The percentage of OTs working with psychiatric diagnoses has dropped precipitously |
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Term
Reasons why OTs aren't working in the mental health sector as much |
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Definition
OT became too invested in the medical model
This has left OTs in the hospital and with the deinstitutionalizing of the mentally ill the structure changed.
Many went to the schools |
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Term
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Definition
looks for causal factors such as social relationships, environmental barriers and societal stressors that may contribute to a person's dysfunction
Change occurs through supportive social relationships and social advocacy |
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Term
psychosocial rehabilitation |
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Definition
combines the social model with the rehabilitation model which is familiar to OTs.
community-based mode of service provision-began with the Horizon House in Philadelphia
Intentionally informal reducing the distance between patients and staff. Members are active participants.
4 services offered 1. social/recreational 2. vocational 3. residential 4. educational
social workers are dominant pros in psychosocial rehab. These facilities don't seem to try and get OTs as much as Social Workers but |
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Term
Three aspects of OT that could be especially useful in psychosocial rehabilitation |
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Definition
1. Emphasis on functional outcomes 2. Developmental perspective 3. activity analysis |
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Term
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Definition
those illnesses and disorders, other than substance misuse and addictive disorders defined in the DSM IV-TR
Also called brain disorders (National Alliance for the Mentally Ill) An effort to reduce stigma |
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Term
Community Mental Health Centers (CMHCs) |
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Definition
established to provide mental health services in the community as an alternative to state hospitals. They were found to not meet the needs of those with serious mental illness. |
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Term
Community Support Program |
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Definition
National Institutes of Mental Health 1977 states received funding to set up community-based programs to address the needs of persons with serious mental disorders who had been deinstitutionalized from state hospitals. (PACT and Fountain House) They have proven effective. |
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Term
review of the DSM IV-TR axis |
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Definition
Axis I- primary psychiatric diagnosis Axis II- personality disorder and MR Axis III physical and mental conditions Axis IV level of environmental stressors experienced by the client Axis V cient's current level of functioning
IV and V most relevant to OT |
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Term
positive symptoms of schizophrenia |
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Definition
those that are present like delusions and hallucinations |
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Term
negative symptoms of schizophrenia |
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Definition
those things that are missing from the person These are the symptoms that OT directly addresses in functioning.
flat affect alogia avolition anhedonia (lack of pleasure) asociality attentional impairment |
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Term
stress vulnerability model |
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Definition
originally supposed to explain occurrence of symptoms of schizophrenia through understanding of the interaction of environmental stressors and personal vulnerabilities inherent
It ended up being a model particularly helpful in understanding the exacerbation and remission of symptoms in individuals with mental health disorders living in a community setting.
ACCORDING TO THIS MODEL, THESE EPISODES ARE PROMPTED BY "ORDINARY" ENVIRONMENTAL STRESS IN VULNERABLE INDIVIDUALS. IN A VULNERABLE INDIVIDUAL THIS "ORDINARY" LEVEL OF STRESS CAN ALSO BE RESPONSIBLE FOR A CONTINUING PERIOD OF SIGNIFICANT SYMPTOMS AND DIMINISHED FUNCTIONING.
The degree of intrinsic vulnerability is inversely related to the level of stress that provokes acute episodes of mental disorder.
Each relapse directly increases vulnerability and the likelihood of future relapse. Each time they become hospitalized they become more of a "patient". |
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Term
Program for Assertive Community Treatment Act (PACT) |
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Definition
began in 1972 in Wisconsin due to closing of state hospital units
One hospital ward's treatment staff moved into the community with their patients providing intensive treatment, rehab. and support services to clients in their homes, at their jobs and in social settings.
Multidisciplinary mobile mental health agency.
Members function as a transdisciplinary team taking on all roles to provide services that are available when and where clients need them.
THE TEAM IS THE PRIMARY PROVIDER OF SERVICES AND THE FIXED POINT OF RESPONSIBILITY FOR THE CLIENT.
services are highly individualized and intense
Delivery of services depends on client and client's preferences
Clients are not referred to other specialists but worked with by the "team" of professionals.
Finding and keeping a job is central to the PACT model.
Effects are proven but results not sustained upon exiting |
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Term
psycho-educational approach |
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Definition
Info. about the illness and its management is provided to consumers and families to foster active engagement in the treatment and recovery process.
Information is carefully selected and provided in a manner helpful to the consumer and his or her family.
4 phases 1. connection with the family 2. survival skills workshop 3. repetition of opportunities to apply and practice these new skills 4. continuing family therapy or disengagement
In some programs the consumers take the student role in place of the patient role and attend classes, do homework and use educational media-have homework and are included in discussion. |
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Term
psychiatric or psychosocial rehabilitation (second definition) |
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Definition
tried to apply the principles of physical rehabilitation to mental illness in order to achieve independent functioning in the community
Services focus on an extensive evaluation of individual strengths and weaknesses determined from detailed history taking and personal review.
Community supports are identifies and the need for environmental modification is determined. restoration of skills is desired and can be set as goals. Every individual is perceived as having the ability and need to be productive through paid or unpaid employment.
Focus is function rather than the intrapsychic processes.
Health is achieved through meaningful occupationa and the understanding that change can be effected through client choice and engaging in activities that promote skill building, exploration, education and community role development. |
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Term
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Definition
structured psychosocial rehabilitation approach.
All former patients (from state hospital) who participate in the program are considered members of the club. They are "members".
Expected to come to club daily
expected to participate in the club's work units at the level of capability
Work is paid for through the transitional work program.
Being productive and needed is extremely important for its regenerative and generative properties.
Daily occupation is structured into a work unit structure n order to perform necessary club functions.
OT roles range from clinical to administrative. Clinical roles being member evaluator, and interview techniques, direct interaction
Administrative roles include managing the clubhouse program, supervising staff in the implementation of the service plan and managing and developing the vocational programs. |
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Term
treatment settings for mental health |
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Definition
Ambulatory Behavioral Health Care
Three levels 1. Partial Hospitalization Programs- provides crisis intervention and is an alternative to the state hospital. Acute symptoms, need full time care with attendance in a day long program at least four days per week. Can be daily contact in the clients' home or facility-therapy includes evaluation especially for safety and both group and individual therapy. OT critical in PHPs due to extremely short length of stay following client admission and need for intense after care services upon discharge.
2. Ambulatory level 2 are those that have a structure staff-supported milieu and involve active treatment with a rehabilitation or transitional focus.Program extends into community and client attendance is flexible based on need. Intensive outpatient programs and psychosocial rehab. programs are examples of this level. Include day treatment or day-care programs.
3. delivered as part of coordinated treatment plan but do not necessarily involve structured program activities. These are less extensive than level 2 but more extensive than outpatient care involving more hours of intervention, variety of treatment modalities and availability of 24-hour crisis intervention. |
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Term
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Definition
work is seen to have a stabilizing effect, reducing the chance of relapse and promoting improved health and well-being. |
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Term
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Definition
different from hierarchal train and place model
consumers are evaluated, receive rehabilitation services and then begin vocational training.
also called the choose, get and keep model
consumer is assessed, consumer selects an area of employment with the assistance. Skills and skill deficits relative to the job are noted. Skill deficits are addressed by direct training and/or modifying the physical or social environment. The consumer is then trained on the job directly by the employer with the support of his or her job coach. |
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Term
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Definition
protected environments where persons with disabilities are paid for low-skilled, factory-type assembly work. They have been crticized for creating dependency and not preparing workers for real-life employment. |
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Term
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Definition
developed as part of Fountain House
involves procurement of a job in a normal place of business htat pays the prevailing wage and will allow job coaching on the job site.
The job is shared by several members of the club for a predetermined time period, usually three months. It gives members an opportunity to practice both their work and social interaction skills on a part-time basis.
OT acts as managers and in this role, learn the job, train the members and provide job coaching using task analysis and task and environmental modification. |
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Term
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Definition
began with developmental disabilities.
used extensively in the field of psychosocial rehabilitation in clubhouse programs or those providing primarily vocational services.
after assessment , teh person is matched to a job as described previously.
job coach works with the employer to train the individual to perform the job and makes recommendations for appropriate accommodations.
employer is educated about mental illness, focusing on the abilities and reliability of workers.
job coach works in conjunction with a case manager or other professional to assist the consumer with recurring symptoms, medication changes or other issues. |
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Term
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Definition
run in many clubhouses for members on TE or in competitive employment. Also done in outpatient settings
much like a support group for anything else |
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Term
assessments for vocational programming with the mentally ill |
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Definition
allen's cognitive level
jacob's prevocational skills assessment-evaluates basic problem solving, categorizing and sequencing
bay area functional performance evaluation (BAFPE) social interaction scale to determine difficulties and strengths in interpersonal interaction
cognitive assessment of Minnesota- assesses complex problem solving and memory retention
also Assessment of motor and process skills
self-assessment of occupational function
occupational history |
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Term
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Definition
OT can help employers understand what "reasonable accommodations" means with the mentally ill. they need to understand the limits around which they must comply.
Advocacy in educating employers about the causes and treatment of mental illness and to help employees success.
examples: structure work environment with less distractions provide frequent supervision, frequent breaks assessing the environment prior to beginning of work
employee must disclose that they have a psychiatric disability sometime after being hired. |
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Term
major difference between a social worker and an OT in home health |
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Definition
The OT practitioner's primary focus is rehabilitative.Evaluating the impact of severe anxiety, depression, memory impairments, agoraphobia, impaired judgment, impaired safety awareness and paranoid delusions on function.
SOcial workers address legal and financial issues, family dynamics and use of community resources |
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Term
partial hospital programs |
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Definition
(again level 1 of the ambulatory care)
based in hospitals as outpatient services or in community mental health programs. Most OTs in mental health are employed at these.
paid for by Medicaire and private insurers prospective payment system-
unlike payment the payment system for skilled nursing facilities (SNFs) there are no categories that account for patient severity. The daily rate is an average of all patients. OT is bundled into the day rate of $208 per day |
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Term
SAMHSA- Substance Abuse and Mental Health Services Agency |
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Definition
Each state receives about 10 percent of its state mental health budget from the federal government through this agency.
Each state must have a mental health advisory planning council which provides input on how the money is spent in order to receive funds. (must be 50% consumers and families and the rest stakeholders)
Opportunity for OTs to be involved at the planning stage and possibly influence the inclusion of OT in more community programs |
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Term
clinical case management model |
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Definition
the case manager addresses the overall maintenance of each individual''s physical survival and personal growth.
Both recovery and adaptation to the mental illness and participation in community life. 1. services provided in vivo 2. goals are to reduce hospitalization, maintain the client in the least restrictive community setting possible and maintain quality of life. 3. a team or an individual serves as a fixed point of reponsibility 4. service is of unlimited duration 5. service will provide continuity of care over time and across referral agencies.
unlike hospital or community rehab. case management focuses on assisting the client in gaining the basic life necessities, managing their mental illness and participating in community life. |
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Term
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Definition
involves providing information and expert advice regarding program development and evaluation, supervisory models, organizational issues and/or clinical concerns |
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Term
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Definition
not just "treating" the client
understanding the person's current ability to perform necessary tasks and analyzing skills needed to perform those tasks, adapting the environment to promote the highest level of function. |
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Term
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Definition
process of establishing priorities, diagnosing problems and allocating resources to achieve objectives. |
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Term
seven principles common to all planning models |
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Definition
1. preplanning
2. needs assessment
3. program plan development (after determining priorities)
4. implementation
5. process evaluation
6. impact/outcome evalutaion
7. Share results |
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Term
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Definition
systematic set of procedures that serves to identify and describe specific areas of need and available resources in a given population, discover factors that contribute to the identified problem, establish priorities and devise criteria for interventions that will address the need
usually a survey will bring forward a need that is not being met.
not intended to provide diagnostic info. about individuals
The purpose is to make decisions about priorities for programs and services that affect groups of people.
A need is the gap between the present state of affairs and some desired future state for a particular group with an identified issue. |
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Term
most effective type of survey |
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Definition
(for needs assessment)
asks people for their opinions based on their own experiences, background expertise or knowledge or for facts about themselves and others about whom they have direct knowledge |
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Term
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Definition
aside from surveys these are the most frequently used method of collecting qualitative data for needs assessments.
provide face-to-face interactions with groups of stakeholders in a variety of discussion formats most commonly open forums, focus groups and nominal group processes.
also includes the agency representative in contact with the target population
valuable when used in conjunction with other methods and sources |
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Term
factors to consider when doing a needs based assessment |
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Definition
characteristics of the target group and the survey respondents-socioeconomic factors, literacy, language, availability, and level of ability that may all influence the info. that is gathered
type of info. desired. Best to choose a combo. of methods that yield different types of information both qualitative and quantitative
resources available-time, money, and human resources
The amount of interaction desired with the audience. Some methods offer greater opportunity for dialogue with members of the target audience. Those may be more costly or harder to analyze |
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Term
factors to consider when doing a needs based assessment |
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Definition
characteristics of the target group and the survey respondents-socioeconomic factors, literacy, language, availability, and level of ability that may all influence the info. that is gathered
type of info. desired. Best to choose a combo. of methods that yield different types of information both qualitative and quantitative
resources available-time, money, and human resources
The amount of interaction desired with the audience. Some methods offer greater opportunity for dialogue with members of the target audience. Those may be more costly or harder to analyze |
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Term
factors to consider when doing a needs based assessment |
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Definition
characteristics of the target group and the survey respondents-socioeconomic factors, literacy, language, availability, and level of ability that may all influence the info. that is gathered
type of info. desired. Best to choose a combo. of methods that yield different types of information both qualitative and quantitative
resources available-time, money, and human resources
The amount of interaction desired with the audience. Some methods offer greater opportunity for dialogue with members of the target audience. Those may be more costly or harder to analyze |
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Term
factors to consider when doing a needs based assessment |
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Definition
characteristics of the target group and the survey respondents-socioeconomic factors, literacy, language, availability, and level of ability that may all influence the info. that is gathered
type of info. desired. Best to choose a combo. of methods that yield different types of information both qualitative and quantitative
resources available-time, money, and human resources
The amount of interaction desired with the audience. Some methods offer greater opportunity for dialogue with members of the target audience. Those may be more costly or harder to analyze |
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Term
process of data analysis and interpretation in a needs based assessment |
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Definition
raw data gathered data is analyzed analyzed data presented to stakeholders in an easily understandable manner interpretation |
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Term
needs assessment vs. program plan development |
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Definition
needs assessment focuses on the ends to be attained
the development of a program plan focuses on the means or solutions. this is done by using the findings of the needs assessment |
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Term
needs assessment vs. program plan development |
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Definition
needs assessment focuses on the ends to be attained
the development of a program plan focuses on the means or solutions. this is done by using the findings of the needs assessment |
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Term
Theory (as it relates to program development) |
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Definition
an explanation of why a phenomenon occur the way it does.
good theories complement practical skills and technologies by taking the program beyond simply conducting activities to solve problems. They can provide answers to a program developer's questions about why people engage or don't in behaviors and how to engage people in changing behaviors and what factors to focus on in the evaluation. |
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Term
deciding if a theory is a good fit |
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Definition
if a theory is a good fit the theory will make assumptions about a behavior/health problem, or condition of people or the environment that are 1. logical2. consistent with everyday observations 3. similar to those used in previous successful programs and 4. supported by past research in the same or related area. |
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Term
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Definition
goals(long term) objectives-ued to reach goals-measurable strategies evaluation plan |
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Term
objectives of a program plan |
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Definition
identify who ( clients/participants) what (action/performance) when (time frame)
EX: within six months of completing the fall prevention course, 75 percent of participants will be continuing their balance exercises |
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Term
ecological perspective in health promotion |
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Definition
health behavior both influences and is influenced by the environment (reciprocal causation)
five societal levels in which planners can intervene 1. intrapersonal 2. interpersonal 3. organization 4. community 5. public policy
2 of the ecological frameworks include programs called Precede-proceed and MATCH |
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Term
different types of objectives |
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Definition
health objective- reduce falls due to injury program objective-addresses the process of intervention- program with reach over 300 adults over 60 in 15 senior centers learning objective-participants will be able to identify at least four risk factors for falls behavioral objective-within 6 months participants will be continuing their balance exercises at their goal level. resource objective-addresses material -home assessments will be provided to all interested clients who attend the fall prevention course. |
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Term
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Definition
1.process 2. impact 3. outcome |
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Term
occupations and subtsance use |
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Definition
occupational deprivation occupational alienation and habit dysfunction |
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Term
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Definition
sense of isolation or estarngement a person experiences as a result of engagement in occupations that are not personally meaningful and fulfilling. |
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Term
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Definition
refers to circumstances beyond the person's control that result in limited occupational choices |
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Term
substance use disorders include |
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Definition
substance abuse and substance dependence |
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Term
substance dependence includes |
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Definition
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Term
substance dependence includes |
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Definition
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Term
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Definition
failure to fulfill major role obligations at work, school or home. |
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Term
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Definition
experience less severe role disruptions, take only minimal physical risks and have fewer legal and social problems. Close friends or family may notice beginning problems in controlling the use of alcohol and the individual may be concerned about the effect of using on his or her behavior
treatment is aimed on moderation not abstinance |
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Term
substance use and schizophrenia |
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Definition
persons with schizophrenia are six times more likely to develop a drug use disorder and three times more likely to develop an alcohol problem when compared to the general population. Persons with a bipolar disorder are seven times more likely to develop problems with substances |
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Term
according to the reading what does a person lose when they use alcohol or drugs |
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Definition
they lose intentionality-the creation of reasons for doing. Reasons for doing are the basis of volition or making choices for occupational behavior.
the person fails to enact intentions for doing other important tasks and activities. Instead the person becomes focused on maintaining the euphoria associated with using substances. |
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Term
what happens to those who fall victim to addictions |
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Definition
occupational behavior represents the "meaning that we make of ourselves acting in the world"
people addicated to substances have gradually assumed a negative self-image |
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Term
process of occupational alienation |
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Definition
as the substance use progresses the individual becomes more and more alienated from normal occupations and becomes deprived of healthy effects. Further engagement in nonusing occupation becomes devoid of usual meanings, only meaningful to the extent that these occupations serve as barriers or facilitators to drinking or using drugs. |
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Term
process of occupational alienation |
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Definition
as the substance use progresses the individual becomes more and more alienated from normal occupations and becomes deprived of healthy effects. Further engagement in nonusing occupation becomes devoid of usual meanings, only meaningful to the extent that these occupations serve as barriers or facilitators to drinking or using drugs. |
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Term
what is the focus of treatment now with those who have substance use issues? |
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Definition
helping people prepare themselves for the next stage of change-not trying to break through "denial"
This is done by a consistent effort to bring the addiction to the client's level of awareness. |
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Term
stages of change in addiction (Prochaska and DiClemente) |
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Definition
1. precontemplation 2. contemplation 3. determination 4. action 5. maintenance 6. relapse
The stages are a continuous sycle that one may enter or exit at any point, may progress or regress or remain in a given stage for an undetermined length of time.
during precontemplation the client may be surprised by any mention that the problems they are experiencing have anything to do with the addiction. |
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Term
goals of prevention as related to the stages of change involve: |
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Definition
bringing the risky behaviors to the person's attention helping the person to determine the need to change these risky behaviors Facilitating the decision to change and selecting strategies for change Implementing the change strategies Maintaining the new healthy behaviors Reinstituting the healthy behaviors when lapsing into old habit patterns and behaviors |
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Term
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Definition
occurs during a drug or alcohol "crisis' it is usually an acting out a desire to change. This can be used to the advantage of the therapist
involves evaluation of the lethality of suicidal or homicidal gestures; the potential for violence or other negative and unpredictable behaviors. |
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Term
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Definition
involve offering clients well-written educational materials, conducting health screenings, discussing information about substance use, or providing information about resources- found to be effective in motivating change |
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Term
motivational enhancement therapy (MET) |
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Definition
four highly structured sessions includes drinker's check up (DCU) and the FRAMES approach to interviewing for change (CAGE, MAST) part of the DCU |
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Term
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Definition
CAGE is four questions asked about 1. need for Cutting down 2. feeling Annoyed by others criticizing one's drinking 3. feeling Guilty about drinking 4. needing and Eye opener (drink first thing in the morning). two positive answers on CAGE indicates a drinking problem-12 drinks per week woman or 15 for man |
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Term
MAST-Michigan Alcohol Screening Test |
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Definition
analyzes the social, medical,lgal and psychosocial consequences associated with problematic drinking-black outs, loss of employment and drunk driving arrests. |
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Term
|
Definition
CAGE is four questions asked about 1. need for Cutting down 2. feeling Annoyed by others criticizing one's drinking 3. feeling Guilty about drinking 4. needing and Eye opener (drink first thing in the morning). two positive answers on CAGE indicates a drinking problem-12 drinks per week woman or 15 for man |
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Term
FRAMES-feedback Responsibility, Advice, Menu, Empathy and Self-efficacy |
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Definition
throughout the interview the professional gives clear and specific feedback from the assessment that supports the need for change.
The emphasis is on the person's responsibility to interpret and act on the info. The interview gives advice in relationship to the medical conditions of continued use. The pro supplies a menu of change options. The pro is empathetic and avoids hostile confrontations, power struggle and judgmental attitudes. The professionals attitude promotes the self-efficacy of the client in their ability to make decisions about when and how to change
can take a long time-the individual is not always able to absorb all of it at once. |
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Term
Rational Recovery, Sobriety Save Our Selves (SOS) Women for Sobriety (WFS) |
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Definition
secular organizations for those who are not comfortable with a spiritual emphasis. Rational Recovery has a professional advisor and allows for moderate drinking or abstinence. WFS says that women are competent they do not need alcohol and drugs to cope |
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Term
Rational Recovery, Sobriety Save Our Selves (SOS) Women for Sobriety (WFS) |
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Definition
secular organizations for those who are not comfortable with a spiritual emphasis. Rational Recovery has a professional advisor and allows for moderate drinking or abstinence. WFS says that women are competent they do not need alcohol and drugs to cope |
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Term
Rational Recovery, Sobriety Save Our Selves (SOS) Women for Sobriety (WFS) |
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Definition
secular organizations for those who are not comfortable with a spiritual emphasis. Rational Recovery has a professional advisor and allows for moderate drinking or abstinence. WFS says that women are competent they do not need alcohol and drugs to cope |
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Term
Factors affecting long-term recovery |
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Definition
those at highest risk of relapse or poor long-term recovery: unmarried lack stable family situations lack employment live in low-income communities
substance use disorders are inextricably linked to the individual's social environment |
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Term
addiction is associated with: |
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Definition
a lack of meaning and purpose in life |
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